Treatment for Gallstones in the Bile Duct
ERCP
It is a gold standard technique because it is not only a diagnostic procedure but therapeutic as well. If during visualising gallstones are found in the bile duct, then the duct is dilated and this procedure is termed as endoscopic sphincterectomy, which allows the bile to pass freely to the duodenum and a tiny incision is also made to capture the gallstone in a tiny basket and then taken out. A stent is sometimes also placed in the duct so that it remains open. Complications can also occur due to this procedure which includes:
- Acute pancreatitis
- Perforations
- Bleeding
- Post-interventional infections
Choledochotomy
It is undertaken when minimally invasive technique Like ERCP is not available. In this procedure patient undergoes laparotomy (opening up the abdomen by a large incision). The aim of this surgery is to drain the common bile duct and remove the stones by a longitudinal incision in the duct. When the duct is clear of stones, a T-tube is inserted and the duct is closed around it; the long limb of the T-tube is brought out on the right side, and the bile is allowed to drain externally. When the bile has become clear and the patient has recovered, a cholangiogram is performed and if the X-rays show no stones then the tube is removed and the incision is then closed.